Gut Liver.  2018 May;12(3):271-277. 10.5009/gnl17138.

Factors Associated with Rebleeding in Patients with Peptic Ulcer Bleeding: Analysis of the Korean Peptic Ulcer Bleeding (K-PUB) Study

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. gastro@catholic.ac.kr
  • 2Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 3Deparment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 4Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • 5Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
  • 7Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
  • 8Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 9Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 10Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • 11Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
  • 12Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
  • 13Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 14Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 15Department of Internal Medicine, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 16Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea.
  • 17Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
  • 18Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea.
  • 19Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University College of Medicine, Daegu, Korea.
  • 20Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 21Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 22Department of Internal Medicine, Eulji University College of Medicine, Daejeon, Korea.
  • 23Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 24Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 25Department of Internal Medicine, Sahmyook Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 26Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 27Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
  • 28Department of Internal Medicine, National Medical Center, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Rebleeding is associated with mortality in patients with peptic ulcer bleeding (PUB), and risk stratification is important for the management of these patients. The purpose of our study was to examine the risk factors associated with rebleeding in patients with PUB.
METHODS
The Korean Peptic Ulcer Bleeding registry is a large prospectively collected database of patients with PUB who were hospitalized between 2014 and 2015 at 28 medical centers in Korea. We examined the basic characteristics and clinical outcomes of patients in this registry. Univariate and multivariate analyses were performed to identify the factors associated with rebleeding.
RESULTS
In total, 904 patients with PUB were registered, and 897 patients were analyzed. Rebleeding occurred in 7.1% of the patients (64), and the 30-day mortality was 1.0% (nine patients). According to the multivariate analysis, the risk factors for rebleeding were the presence of co-morbidities, use of multiple drugs, albumin levels, and hematemesis/hematochezia as initial presentations.
CONCLUSIONS
The presence of co-morbidities, use of multiple drugs, albumin levels, and initial presentations with hematemesis/hematochezia can be indicators of rebleeding in patients with PUB. The wide use of proton pump inhibitors and prompt endoscopic interventions may explain the low incidence of rebleeding and low mortality rates in Korea.

Keyword

Peptic ulcer hemorrhage; Rebleeding; Risk factors

MeSH Terms

Hemorrhage*
Humans
Incidence
Korea
Mortality
Multivariate Analysis
Peptic Ulcer Hemorrhage
Peptic Ulcer*
Prospective Studies
Proton Pump Inhibitors
Risk Factors
Proton Pump Inhibitors
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